不同直径股骨头假体用于全髋关节置换的中期疗效对比

Comparison of Mid-Term Results of Femoral Head Prostheses with Different Diameter for Total Hip Arthroplasty

目的比较不同直径股骨头假体用于全髋关节置换的中期疗效差异。方法回顾分析2010年3月至2013年9月共42例初次行全髋关节置换术治疗终末期髋关节疾病的患者,其中21例采用36 mm大直径陶瓷股骨头假体(大直径组),21例采用32 mm小直径陶瓷股骨头假体(小直径组)。随访5年以上,通过Harris髋关节评分和X线片评估疗效差异。结果所有患者平均术后随访时间为(69.71±4.03)个月。末次随访所有患者的Harris髋关节评分与术前相比均显著提高(84.48±9.06 vs 40.21±9.05,P<0.001),且大直径组的髋关节评分显著高于小直径组(89.38±9.36 vs 79.57±5.51,P<0.001)。末次随访X线片示所有患者的假体位置均良好,两组均未见假体脱位。结论大直径股骨头假体的中期临床效果满意,与小直径假体相比可更好地改善术后关节活动度。

Objective To compare the difference of mid-term outcomes of femoral head prostheses with different diameter for total hip arthroplasty.Methods Retrospective analysis of 42 patients who underwent total hip arthroplasty for end-stage hip disease from March 2010 to September 2013 was conducted.Among them,21 cases adopted 36 mm large-diameter ceramic femoral head prosthesis(large diameter group),and 21 cases adopted 32 mm small-diameter ceramic femoral head prosthesis(small diameter group).All the patients were followed up for more than 5 years,and differences in efficacy were assessed by Harris hip score and X-ray.Results The mean postoperative follow-up time was(69.71±4.03)months.Up to the last follow-up,the Harris hip score of all patients was significantly higher than that before surgery(84.48±9.06 vs 40.21±9.05,P<0.001),and the Harris hip score of the large diameter group was significantly higher than that of the small diameter group(89.38±9.36 vs 79.57±5.51,P<0.001).The final follow-up X-ray showed that the prosthesis position of all patients was good,and no dislocation of prosthesis was observed in both groups.Conclusion The mid-term outcome of the large-diameter femoral head prosthesis is satisfactory,and the postoperative joint mobility was improved better than that of the small-diameter prosthesis.